Speech disorder classification

• Classification of speech disorders include central defects and disorders, neurotic defects, vocal cord defects, articulation disorders, and voice disorders.

Central Defects and Disorders

• Developmental dysphasia is a specific disturbance of speech development resulting from early brain damage affecting speech zones in a developing brain prenatally.
• It manifests as a difficulty learning to communicate verbally despite adequate conditions for speech development, which generally has a good prognosis for improvement.
• Aphasia is the loss of already learned abilities to communicate with spoken, written, and read language caused by damage to the left cerebral hemisphere, mostly from post-traumatic conditions in children or stroke, injury, or tumors in adults.
• The symptoms are highly variable and dynamically change within the same individual over time.
• Cluttering refers to a speech tempo disorder characterized by an extremely accelerated speech rate, where many symptoms are dominated by an excessive speech tempo, resulting in the omission of syllables, mispronunciations, repetitions of syllables, and deformation of content.
• Stuttering (stammering) refers to a disturbance in the smoothness of speech due to spasms in the respiratory, vocal, and articulatory muscles and the discoordination of their activities during speech.
• It presents as interruptions in speech such as tension or prolongations of especially initial syllables or words or repetitions of syllables or words.
• Individuals are aware of their handicap, which can gradually change their attitude towards verbal communication, and they may secondarily avoid speaking.
• Accompanying signs may appear, such as grimaces of the facial muscles and dilation.

Neurotic Defects and Disorders

• Mutism is a loss of speech based on neurotic or psychotic background, possibly from psychological trauma, and typically tied to childhood.
• Selective mutism involves an unwillingness to speak to specific individuals or in certain situations or environments, and often can be attributed to inappropriate upbringing.

Vocal Cord Defects

• Rhinolalia (nasality) refers to a disorder affecting nasal resonance during speech.
• Closed nasality is caused by insufficient nasal patency, whereas open nasality results from a malfunction of the palatopharyngeal closure.
• Palatolalia refers to a speech disorder associated with cleft palate.

Articulation Disorders

• Dyslalia involves defective pronunciation of one or more sounds, either by replacing them with other sounds (paralalia) or omitting them (mogilalia).
• Individual types of dyslalia are labeled according to the letters of the Greek alphabet (sigmatism, rotacism) and is the most common disorder.
• Nearly half of first-graders mispronounce certain sounds, which may complicate their successful adaptation to the school environment.
• Exogenous causes include environmental influences; endogenní causes include impaired auditory and visual perception, anatomical abnormalities or damage to the articulation organs, neuromotor disorders, heredity, and linguistic cognitive deficits.
• Dysarthria refers to a comprehensive articulation disorder that accompanies conditions such as infantile cerebral palsy or Parkinson's disease.

Voice Disorders

• Hoarseness results from pathological changes in the vocal cords.
• Organic voice disorders include congenital anomalies, Down syndrome, paralysis, tumors, injuries, and hearing disorders.
• Functional voice disorders result from excessive use of the voice.
• A voice disorder may be an initial symptom of a condition, where a temporary change in voice (hoarseness, voicelessness) persists for more than two weeks, requiring professional help from an ENT specialist or phoniatrics/speech therapist.
• The incidence of voice disorders is between 24% to 38% in elementary school children; a small percentage of diagnosed children receive voice therapy.
• Prevention includes vocal hygiene and avoiding unnecessary shouting and teaching correct speech patterns; music lessons should be carefully monitored.